Osteopathic Considerations in Scoliosis

According the American Association of Neurological Surgeons, scoliosis affects 2-3% of the population in the United States, which translates to roughly six to nine million people. Many of those people will experience back pain at some point that will stem from the abnormal curve or curves in their spine. A normal back has curves in it that develop starting with a cervical lordosis (the curve in our necks) when we learn to hold our heads up as babies. In scoliosis, the curves move from side to side instead of front to back. Scoliotic curves can be C-shaped or S-shaped. Regardless of which type or the intensity of the angle, osteopathic manipulative medicine can typically help with symptoms resulting from scoliosis. In determining how to address the scoliosis, it is important to address the pelvis, the spine, the ribs, the junction between the head and the neck, and the cranial bones themselves.

Two patients come to mind when I think about how different each person is and how differently each person presents with their problems. After several treatments, both women responded differently to osteopathic treatment due to the differing areas that were affected by their spinal curves.

The first patient was 13 years old when she came to see me as a patient. She was active in school sports, but experienced headaches, back pain and joint pain in her knees, ankles, and hips due to severe scoliosis. As a patient she drove home the point about how important it can be to treat the whole body. Had I solely treated her spine, she probably would not have had much relief.

When I did treat her I started from the feet up, making sure that her feet and ankles were moving well and as symmetrically as possible from one side to the other. Then it was imperative to address her lower legs and femurs (hip bones) to make sure that there was no strain causing her knee or hip pain. During every visit, I spent a great deal of time treating her sacrum and pelvis to make sure that her spine had a flexible and moving foundation on which to sit. Her spine demanded time to improve mobility, as well as her ribs because the ribs and spine form functional units that work together and can either allow for movement or stasis. Then it was necessary to treat any strain in her cranial bones so that her head could sit more symmetrically on top of her neck. Her cranial bones had strain that needed to be addressed every time she came in, which when treated would calm her headaches. Finally I worked to make sure that her head sat on her neck symmetrically, so that her eyes would be level with the horizon. This young woman was helped when she was treated regularly, but was not able to continue treatment long enough to produce lasting improvement.

The second patient was 71 years old when she came to be treated. She had severe scoliosis from childhood. When she came in for her initial visit she complained mostly of fatigue and finding herself easily short of breath. As a toddler she had multiple surgeries in her lung to address an infection, which she believed caused the beginnings of her scoliosis. By the time she came in as a patient her thoracic spine was visibly sidebent. Remarkably after three treatments she began to feel more energetic and did not get easily short of breath after walking short distances. Before she started treatment she would need a nap every afternoon because of her fatigue. By the end of three weeks of treatment she no longer needed to rest in the afternoons because her energy had improved so dramatically.

The main areas that needed to be addressed for this patient’s recovery were her pelvis, her spine and most of all, her ribs. In her case, her ribs and spine were the most important areas that needed to be mobilized. Once her ribs were moving more evenly and expanding to a larger volume she was able to take in larger breaths of air, and her whole body was better oxygenated. Over the course of several weeks of treatment, this helped her combat the fatigue she had experienced for over sixty years.

Osteopathic manipulative medicine takes into account the need for balance in the body as a whole. Sometimes certain areas need more attention than others, like the second patient’s ribs. And sometimes, as in the case of the first patient discussed, the whole body needs to be addressed at every visit. Both of these women show how differently scoliosis can present itself in terms of symptoms, and both highlight how differently people respond to osteopathic treatment.

Thea Bordenave-Sande, DO is a board certified specialist in Osteopathic Manipulative Medicine. After attending the New York College of Osteopathic Medicine in Old Westbury, NY she completed her residency training at St. Barnabas Hospital in the Bronx, NY. Dr. Bordenave-Sande is the founder of Capital Region Osteopathy (formerly Saratoga Osteopathy), located in Slingerlands and can be reached for more information at 518-487-4839 or info@capitalregionosteopathy.com.